NORTHERN IRELAND ADULT SAFEGUARDING PARTNERSHIP · Northern Ireland Adult Safeguarding Partnership...

NORTHERN IRELAND ADULT SAFEGUARDING PARTNERSHIP

NORTHERN IRELAND ADULT

SAFEGUARDING PARTNERSHIP

ANNUAL REPORT

1st

April 2012 to 31st

March 2013

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Northern Ireland Adult Safeguarding Partnership

2 | P a g e A n n u a l R e p o r t 2 0 1 2 - 1 3

CONTENTS

Executive Summary

1. Introduction

2. Workplan

3. Prevention Activity

4. Partnership Working

5. Protection

6. Achievements

7. Governance

8. Activity Analysis

9. Challenges

10. NIASP Workplan 2013-14

11. Appendices



EXECUTIVE SUMMARY

This is the second Annual Report of the Northern Ireland Adult

Safeguarding Partnership (NIASP), and covers the period 1 April 2012 to

31 March 2013.

Adult safeguarding is an emerging area of practice, which covers a wide

range of activities. In 2012 – 13 NIASP adopted a Workplan which

reflected the diverse group of agencies, organisations and individuals

involved in adult safeguarding, and which set out a number of key

priorities in each area. The Workplan was arranged around the following

themes:

1. Leadership and Partnership Working;

2. Public Awareness and Prevention;

3. Access to Adult Safeguarding Services;

4. Effective Interventions;

5. The User Experience;

6. Training and Practice Development; and

7. Governance and Quality Assurance

While the majority of these objectives have been achieved, there are a

number, for example the inclusion of adult safeguarding in the Electronic

Care Record, which will be rolled over into next year.

In 2012 – 13, NIASP brought forward a number of initiatives aimed at

preventing abuse of adults at risk. These focused primarily on

awareness-raising among staff and members of the public so that the

signs and symptoms of abuse are identified quickly and further abuse

can be prevented, and on working at a strategic level to ensure that

adult safeguarding and the prevention of abuse is included in local crime

prevention and community development plans.

Adult safeguarding is a complex task which cuts across many

organisational and professional boundaries. In 2012 – 13 NIASP



established positive partnerships with, amongst others, service users,

the Department of Justice, the Police Service of Northern Ireland and the

Regulation and Quality Improvement Authority.

NIASP produced guidance for practitioners in the form of the Handbook

of General Legal Advice on Safeguarding Adults in Northern Ireland, and

sought to support colleagues working in institutional care settings by the

development of the Abuse in Care training DVD and supporting

workbook.

NIASP also ran a number of successful events, including a conference

to raise awareness of adult safeguarding for staff working in acute care

settings, a seminar on the application of Family Group Conferencing to

adult safeguarding and a workshop on financial abuse.

While NIASP took forward a number of successful initiatives in 2012 –

13, there are also a number of significant challenges which adult

safeguarding must address in 2013 – 14.

Between 1 April 2012 and 31 March 2013 adult safeguarding services

received a total of 5724 referrals. This is an increase of 2120 or 59% on

referrals for the same period in 2011 – 12. In the coming year, NIASP

will seek to find ways of responding to this increase in activity whilst

maintaining the quality of current responses.

The absence of a regional policy statement on adult safeguarding

continues to pose challenges for practitioners, particularly as general

awareness of adult safeguarding continues to grow and as practitioners

develop a more sophisticated understanding of abuse of adults at risk.

NIASP will seek to address these challenges in a measured and

structured way. The Workplan for 2013 – 14 sets out a number of

objectives for NIASP, accompanied by clear rationale which indicate

who is responsible for leading the work as well as setting out the

expected timescale for completion.



1. Introduction:

This is the second Annual Report of the Northern Ireland Adult

Safeguarding Partnership (NIASP), and covers the period 1 April 2012 to

31 March 2013.

NIASP was established in September 2010 to:

“.. determine the strategy for safeguarding vulnerable adults, develop

and disseminate guidance and operational policies and procedures,

monitor trends and outcomes and monitor and evaluate the

effectiveness of partnership arrangements” (Adult Safeguarding in

Northern Ireland, 2010).

NIASP is made up of members from the main statutory, voluntary and

community organisations involved in adult safeguarding work across the

region, including representation from service providers. A full list of

NIASP members is included in Appendix 1.

This report:-

Addresses NIASP’s workplan for 2012 – 13;

Highlights key activities in relation to prevention, protection and

partnership working;

Outlines significant achievements by NIASP in 2012 - 13;

Presents an analysis of adult safeguarding activity in 2012 – 13;

Highlights a number of challenges for 2013- 14; and

Outlines a workplan for NIASP for 2013 -14.



2. Workplan for 2012 – 13:

Adult safeguarding is an emerging area of practice, which covers a wide range of activities and involves a

diverse group of agencies, organisations and individuals. It is vitally important that there is clarity and agreement

about key priorities and objectives, so that adult safeguarding resources can be deployed effectively and

progress measured.

In 2012 – 13 NIASP adopted a Workplan to take forward the development of adult safeguarding services

arranged around the following themes:

1. Leadership and Partnership Working;

2. Public Awareness and Prevention;

3. Access to Adult Safeguarding Services;

4. Effective Interventions;

5. The User Experience;

6. Training and Practice Development; and

7. Governance and Quality Assurance

Each theme was supported by a number of objectives, with associated target completion dates. Responsibility

for taking forward each objective was given either to one of NIASP’s Workstreams or the Regional Adult

Safeguarding Officer. The Workplan was a central part of the agenda for each NIASP meeting, where progress

reports were received from Workstream Leads and the Regional Adult Safeguarding Officer.

This section of the NIASP Annual Report indicates the progress made by NIASP in meeting those objectives as

reported by the Workstream Lead or Regional Adult Safeguarding Officer. Where an objective has been fully or

substantially completed, it is assigned a green status ( ). When an objective has been partially achieved, it is



assigned an amber status ( ). Red status ( ) indicates that limited or no progress has been made in

achieving the objective. Each objective is also accompanied by a brief comment outlining the nature of the

progress made or providing an explanation for lack of progress. All red and amber status objectives have been

rolled over into the Workplan for 2013 – 14.

Theme 1:Leadership and Partnership Working

Rationale: Lead

responsibility:

Status Commentary

Review of

workstream

arrangements

NIASP will review the current

structure of workstreams and

working groups within both

NIASP and Local Adult

Safeguarding Partnerships

(LASPs), and will bring forward

proposals for the more efficient

use of resources

Regional Adult

Safeguarding

Officer

Separate workstreams have been established

to take forward User Engagement and

Communication issues.

Integration with

other regional

strategies

NIASP will develop linkages

with other public protection

awareness-raising campaigns

such as Domestic Violence,

Regional Adult

Safeguarding

Officer

NIASP is represented on the development

groups for the regional Domestic and Sexual

Violence Strategy and on the Community

Safety Strategy Steering Group.



Sexual Violence and Human

Trafficking strategies, to

ensure that adult safeguarding

is an integral part of such

programmes

NIASP is also represented on the Organised

Crime Task Force Immigration and Human

Trafficking Sub-group and the NGO

Engagement group for Human Trafficking,

Chaired by the Department of Justice (DoJ).

NIASP has also responded to a number of

public protection consultations including:

Community Impact Assessments;

PPS Draft Policy re the prosecution of

cases of human trafficking;

Arrangements for the welfare and

protection of victims of human

trafficking; and

EU Directive on Human Trafficking

Improvement of

liaison

arrangements

between NIASP

and RQIA

NIASP will work with the

Regulation and Quality

Improvement Authority (RQIA)

to ensure that lines of

communication between

NIASP and RQIA are effective.

Regional Adult

Safeguarding

Officer

Regular meetings have taken place with

RQIA. However, further work is required to

consolidate communication channels and

ensure that RQIA and NIASP work more

effectively as partners in adult safeguarding.



Theme 2: Public Awareness and Prevention

Introduction of

Safeguarding

Impact

Assessment

Tool

The Screening Tool

developed to assist

organisations assess the

impact of new policies or

strategies on adult

safeguarding will be rolled

out to all NIASP partner

organisations

NIASP

Operational

Policy and

Procedures

Workstream

The DHSSPS are currently in the process of

developing a new regional policy for adult

safeguarding in Northern Ireland. This work

was due for completion in 2012 – 13, but, due

to unforeseen circumstances the finalisation

of this policy has been postponed. It is now

scheduled for public consultation in December

2013. Introduction of the screening tool has

paused pending the finalisation of the new

policy by DHSSPS.

Provision of

awareness

raising

information for

front line staff

NIASP will develop and make

available information and

advice for individuals,

families and carers on

keeping safe and how to

access adult safeguarding

services when necessary

NIASP

Communications

Workstream

Information leaflets for staff developed and

distributed.

Leaflets for service users developed with

assistance of users. Now published and

distributed to Trusts for use as appropriate.



Engaging with

Community

Safety

Partnerships

NIASP and LASP Chairs will

work with the emerging

Police and Community Safety

Partnerships to ensure that

adult safeguarding issues are

given appropriate

consideration at a local level

LASP Chairs;

Regional Adult

Safeguarding

Officer

Each LASP Chair has met with relevant

Managers of the local Police and Community

Safety Partnerships (PCSPs) The PCSPs are

currently identifying local priorities and

developing associated action plans. Further

work is required to set out areas of joint

working or overlap.

Engagement

with Public

Protection

Arrangements

for Northern

Ireland (PPANI )

and Multi

Agency Risk

Assessment

Conferences

(MARAC)

NIASP will continue to work

with PPANI and MARAC

structures to ensure that

adult safeguarding

contributes effectively to

public protection

arrangements in Northern

Ireland

Regional Adult

Safeguarding

Officer

NIASP has undertaken an audit of the adult

safeguarding contribution to the MARAC

process. Proposals for a standardised

approach and application of resources will be

brought forward for consideration by NIASP.



Theme 3: Access to Adult Safeguarding Services

Introduction of

role of

Safeguarding

Adults Manager

(SAM)

NIASP will work with all

partner organisations to

ensure that each

organisation has an identified

Senior Manger designated as

the organisation’s

Safeguarding Adults

Manager (SAM)

NIASP

Operational

Policy and

Procedures

Workstream

Introduction of the role of SAM has paused

pending the finalisation of the new policy by

DHSSPS. This is now scheduled for public

consultation in December 2013.

Ensure the

Electronic Care

Record (ECR)

includes alerts in

relation to adult

safeguarding

NIASP will ensure that the

ECR incorporates information

from SOSCARE and PARIS

and is able to identify adults

at risk with an emerging

pattern of attendance at

Hospital Emergency

Departments

NIASP

Information

Management

Workstream

The inclusion of adult safeguarding

information in the ECR requires staff to have

a working knowledge of alerting signs and

symptoms of potential abuse. Work has

started on raising awareness of these issues

with Hospital Emergency Department staff.

Adult safeguarding is included in the ECR

development schedule for 2013 – 14. This

priority will be included in the NIASP workplan

for 2013 – 14.



Electronic

Referral to adult

safeguarding

NIASP will establish an easy-

to-use, standardised

electronic referral form for

use by all partner

organisations

NIASP

Information

Management

Workstream

An electronic referral form which includes

confidential client information requires access

to a secure network and the development of

Information Sharing Agreements with all

partner organisations. Trust Adult

Safeguarding Specialists now all have access

to the Criminal Justice Secure Messaging

Network system which allows for safe

transmission of confidential information to and

from colleagues in PSNI. Information sharing

agreements in relation to MARAC processes

and the Department of Agriculture and Rural

Development (DARD) are nearing completion.

This priority will be included in the workplan

for 2013 – 14.



Theme 4: Effective Interventions

Ensure a

corporate

response to adult

safeguarding

referrals

NIASP will work with LASP

Chairs to ensure that

individuals who are referred

to adult protection services

but who do not match

Programme of Care

definitions receive an

appropriate response and

level of care and support.

NIASP

Operational

Policy and

Procedures

Workstream and

LASP Chairs

Each LASP/Trust has arrangements in place

to ensure that any adult at risk of harm (eg an

adult victim of Human Trafficking) receives

the appropriate intervention and level of

support.

Review of the

Protocol for Joint

Investigation of

Cases of Alleged

or Suspected

Cases of Abuse

of Adults (2009)

Following the publication of

the RQIA/CJINI joint review

of the Protocol, NIASP, in

partnership with RQIA, the

PSNI and the Public

Protection Service, will

revise the Joint Protocol and

ensure that it is relevant, up-

to-date and fit for purpose.

NIASP

Operational

Policy and

Procedures

Workstream

Work on the revision of the Protocol was

interrupted by service re-engineering and re-

organisation within partner organisations. It

has now resumed and is scheduled for

completion in the autumn of 2013.



Theme 5: The User Experience

Establish a

formal

mechanism to

enable NIASP to

engage with

Service Users

NIASP will bring forward

proposals for effective

engagement with users of

adult safeguarding services

NIASP User

Engagement

Workstream

E-forum established with 20 members.

Contributions have been sought in relation to

the use of Family Group Conferencing and

the draft Strategic Plan.

Theme 6: Training and Practice Development

Development of

a Regional

Training Strategy

for Adult

Safeguarding

NIASP will develop and

agree a menu of adult

safeguarding training

opportunities which will

specify learning outcomes,

core content and target

groups to meet a range of

identified training needs

NIASP Training

Workstream

The NIASP Training Workstream has

developed a strategic approach to training

which outlines the different expectations of

staff in the various roles and responsibilities

they hold. The Training Strategy has been

adopted by all NIASP member organisations.



Clarification and

strengthening of

NIASP

Governance

Arrangements

NIASP will develop and

publish a governance

scheme which will set out

core responsibilities and

accountability arrangements

in relation to adult

safeguarding for NIASP,

LASPs and all partner

organisations

NIASP Chair

and Regional

Adult

Safeguarding

Officer

This is not yet completed. In the interim,

NIASP will act within the Governance Scheme

of the HSCB and the governance

arrangements outlined in Adult Safeguarding

in Northern Ireland (2010).

Audit of

safeguarding

activity

NIASP will undertake an

audit of the role and

contribution of adult

safeguarding within MARAC

arrangements

Regional Adult

Safeguarding

Officer

This audit is nearly completed. NIASP will

consider the findings in due course.



3. Prevention Activity:

In the past, adult safeguarding has focused primarily on the investigation

of allegations of abuse and the development of appropriate care and

protection plans for individuals. However, it is vitally important that

expertise and resources are directed towards preventing abuse

occurring in the first place. Whilst most prevention activity will, by its very

nature, take place on a local level, there are also a number of prevention

activities that are require a regional approach.

Within adult safeguarding, prevention has two main strands:

a) Awareness-raising among staff and members of the public so that

the signs and symptoms of abuse are identified quickly and further

abuse can be prevented.

In 2012 – 13 NIASP produced and distributed leaflets targeting

staff reminding them of these signs and symptoms and prompting

them in relation to the actions that they should take to prevent

further abuse occurring. NIASP also published information leaflets

for service users which clarify the different stages of an

investigation and their participation in any investigation and care

and protection plan.

b) Working at a strategic level to ensure that adult safeguarding and

the prevention of abuse is included in local crime prevention and

community development plans.

NIASP is working with the Department of Justice (Community

Safety Branch) to implement significant aspects of the Community

Safety Strategy, including the development of local Police and

Community Safety Partnerships (PCSPs) and responding to hate

based crime, which includes crimes directed against people with

disabilities. The PCSPs are also expected to address fear of crime

amongst older people. These prevention activities are supported

at an operational level by the Local Adult Safeguarding

Partnerships.



4. Partnership Working:

Adult safeguarding is a complex task, and one that is not the sole

responsibility of any one group of staff or agency. Effective safeguarding

requires close and productive collaboration between a range of

disciplines and organisations. These include the PSNI, the RQIA, Health

and Social Care Trusts, the Social Security Agency (SSA), the DHSSPS

and service users themselves.

In 2012 – 13, the following examples of partnership working made

significant contributions to protecting adults at risk of harm:

a) Partnership with users:

NIASP’s User Engagement Workstream has taken forward

proposals to establish an effective online user E-Forum for

individuals and organisations across Northern Ireland who have

experience of, or an interest in, the development of adult

safeguarding services. This is a virtual forum which builds on

existing local and regional user engagement structures and

facilitates meaningful two-way communication with as wide a

range of community and user groups as possible. Membership is

currently at 20 and to date members have been engaged in

sharing their views and experiences of Family Group Conferencing

as well as providing feedback on the content of the draft Adult

Safeguarding Strategy.

b) Department of Justice:

In 2012 – 13 NIASP worked with the Department of Justice (DoJ)

on a number of developments which will either have an immediate

impact on adult safeguarding or have the potential to improve adult

safeguarding over time. These initiatives include:

Provision of Pre-trial Therapy: In January 2012 the

Department of Justice (DoJ) and the Criminal Justice System

Northern Ireland (CJSNI) jointly published “Achieving Best

Evidence in Criminal Proceedings: Guidance on interviewing

victims and witnesses, the use of special measures and the

provision of pre-trial therapy” (ABE).



The guidance makes it clear that the best interests of the

witness are paramount when deciding whether, and in what

form, therapeutic help is given prior to any criminal trial. The

clarity provided through this guidance has assisted

practitioners as they have worked with victims of abuse in

developing Care and Protection Plans.

Introduction of Registered Intermediary Scheme: The Criminal

Evidence (Northern Ireland) Order 1999, as amended by the

Justice Act (Northern Ireland) 2011, made provision for a

range of “Special Measures” for cases involving vulnerable

and intimidated witnesses (including victims as well as

witnesses for both the prosecution and defence) to give their

best evidence in court. One of these special measures is the

intermediary special measure (Article 17). Registered

Intermediaries will help to make the criminal justice process

accessible to some of the most vulnerable people in our

society. In some cases a Registered Intermediary will be the

difference between a victim or witness being able to testify or

not. While the introduction of Registered Intermediaries into

Northern Ireland will require some amendments to existing

protocols for joint working with colleagues in criminal justice

agencies, the availability of this service will undoubtedly

improve access to justice for victims of abuse, neglect and /or

exploitation.

c) Police Service of Northern Ireland: The PSNI is a long standing

partner in adult safeguarding and is central to the successful

protection of adults at risk. While the majority of partnership and

co-working activities are co-ordinated through the Public Protection

Units of the PSNI, in 2012 – 13 NIASP also developed productive

partnership arrangements with some of the more specialist police

services such as the Serious Crime Task Force and fraud

investigation teams.

d) Regulation and Quality Improvement Authority: The RQIA plays a

number of significant roles within adult safeguarding, including

oversight of regulations and standards within regulated services



and facilities, assisting with adult safeguarding investigations and

the audit and review of services. In 2012 – 13 NIASP worked with

RQIA to review safeguarding arrangements in mental health and

learning disability facilities. Work also started with RQIA on the

development of a Human Rights-based approach to adult

safeguarding and on understanding the nature and extent of

financial abuse.

5. Protection:

The title “Protection” covers a diverse range of activity, including the

development of Care and Protection Plans and working with individuals,

their families and carers to reduce the risk of abuse recurring.

In 2011 – 12, NIASP continued the task of revising the Protocol for the

Joint Investigation of Alleged and Suspected Cases of Abuse of

Vulnerable Adults (2009). Work also continued on the development of a

manual of Operational Policy and Procedures. Both these developments

have the capacity significantly to improve adult safeguarding practice.

However, it has proved challenging to progress both these substantial

pieces of work in the absence of a regional policy statement on adult

safeguarding.

NIASP worked with colleagues from Emergency Departments of local

hospitals to develop an adult protection flowchart, which provides

guidance to staff on how to respond to situations of suspected abuse,

neglect and exploitation. It quickly became obvious that this work was

relevant and applicable to a number of areas, including Domestic and

Sexual Violence and Human Trafficking. After consultation with

colleagues in these specialist areas, they were incorporated into the

flowchart. The flowchart is currently being piloted within local Emergency

Departments and will be evaluated in 2013 – 14.

NIASP is represented on the Immigration and Human Trafficking Sub-

group of the Serious and Organised Crime Task Force. To date, adult

safeguarding has responded to only one case of suspected trafficking of

an adult. However, this is an extremely complex and growing area of

work which requires significant investment of time from highly skilled

practitioners.



In 2011 – 12 NIASP had identified Family Group Conferencing as an

intervention which has the potential to assist individuals and their

families to devise and implement a plan to keep an adult at risk safe

from any further harm. In 2012 – 13, NIASP organised a workshop for

practitioners that enabled them to better understand the principles of

Family Group Conferences and also to consider whether it is applicable

to “real life” situations.

6. Achievements:

In addition to working towards the completion of objectives contained in

the Workplan for 2012 – 13, NIASP took forward the following initiatives:

Handbook of General Legal Advice on Safeguarding Adults in

Northern Ireland: Unlike other safeguarding services, there is no

single piece of legislation to underpin adult safeguarding practice

and to support decision making. Where necessary, practitioners

make use of a wide range of legislation drawn from both civil and

criminal practice.

To assist practitioners in this complex area, NIASP commissioned

the Directorate of Legal Services of the Business Services

Organisation to compile a “Handbook of General Legal Advice on

Safeguarding Adults in Northern Ireland”. The Handbook was

launched at an event on 14 May 2012. It was distributed widely

and was also published on the Safeguarding Adults at Risk

Information Hub (SAaRIH).

Abuse in Care DVD: Staff employed in regulated services and

facilities are working with some of the most vulnerable adults in our

society. It is vital that they, and their employers, are fully aware of

the signs and symptoms of abuse and know how to respond if they

have a concern. In 2012 – 13 NIASP commissioned a small sub-

group of the Training Workstream to work with colleagues in the

independent sector to produce a training DVD for staff working in

nursing and domiciliary care settings. The DVD is accompanied by

suggestions for training sessions and a workbook for staff. The

Abuse in Care DVD was formally launched on 14 May 2012.



Adult Safeguarding in Acute Care Settings: On 13 November

2012, NIASP hosted a conference aimed at highlighting the role of

colleagues working in acute care settings in adult safeguarding.

The conference included contributions from the British Medical

Association, Royal College of Nursing and representatives from

acute services. Colleagues from the PSNI highlighted emerging

challenges in relation to Human Trafficking.

The conference provided an opportunity to launch the pilot phase

of the flowchart to support safeguarding practice within Emergency

Departments and successfully raised awareness of adult

safeguarding within the acute sector.

The conference was “live streamed” to the SAaRIH website, which

allowed participants to review the presentations after the

conference and also allowed those people who were unable to

attend to access material from the speakers.

Family Group Conferencing Workshop: A Family Group

Conference (FGC) is a process in which families can be enabled to

meet together, to find solutions to problems that they and the adult

at risk are facing, within a professionally supportive framework.

The FGC process involves all family members, friends and other

adults who the family feel can contribute to making plans for the

adult concerned. Whilst originating in services for children, FGC

has the potential to support families, carers and adults at risk to

ensure that that adult is protected and kept safe from further harm.

A workshop was held on 25 February 2013 which was designed to

allow adult safeguarding practitioners to explore how FGC might

be applicable to adult safeguarding and identify any barriers to

implementation.

Financial Abuse Workshop: In 2012 – 13 there was a significant

increase in the number of referrals to adult safeguarding in relation

to allegations or suspicions of financial abuse. These allegations

range from petty theft through to concerns about the costing

structures within specific services.

Financial abuse poses particular challenges for adult safeguarding

as many of the concerns, such as disposal of assets or property,



sit outside the professional competences of adult safeguarding

practitioners. Indeed, the means to address many of these

concerns sit outside the Health and Social Care system. Dealing

with allegations of financial abuse also requires careful and

sensitive consideration of issues of capacity and consent.

On 8 March 2013, NIASP hosted a workshop on the topic of

financial abuse. The workshop was attended by representatives

from the banking sector, PSNI, the Office of Care and Protection,

DLS/BSO, Health and Social Care Trusts and the independent and

voluntary sector.

The workshop had two main goals; to assist the different

organisations understand each other’s contributions to the

prevention and detection of financial abuse; and to identify the

initial actions required to begin to tackle financial abuse. Taking

forward these initial steps will be a key action for NIASP in 2013 –

14.

Draft Strategic Plan for Adult Safeguarding (2013 – 18): NIASP

has developed a draft Strategic Plan which sets out 7 broad

themes and a number of associated objectives to improve adult

safeguarding over the next 5 years.

The Strategic Plan is currently subject to a process of public

consultation and the final version will be published in early autumn

2013.

7. Governance:

NIASP is currently subject to the governance arrangements within the

HSCB and the requirements set out by the DHSSPS and NIO (now

Department of Justice) in “Adult Safeguarding Arrangements in Northern

Ireland (2010)”.

Work will continue in 2013 – 14 to develop a governance structure for

NIASP which will also set out the necessary governance relationships

with all partner organisations.



In order to progress the adult safeguarding agenda, NIASP has set up 5

Workstreams to address the following areas: Operational Policy and

Procedures; Training and Staff Development; User Engagement;

Communication and Information Management.

Each Workstream is Chaired by a member of NIASP who has the

capacity to co-opt members to the Workstream as appropriate. The

Chairs also provide regular updates on activity and progress towards

achievements set out in the Annual Workplan at each NIASP meeting.

NIASP has also established a number of short-term working groups to

address specific topics such as the development of practice guidance for

staff working in Emergency Departments of acute hospitals. These

working groups are also Chaired by members of NIASP.

The Regional Adult Safeguarding Officer (RASO), on behalf of NIASP,

meets with the Chairs of the Local Adult Safeguarding Partnerships on a

quarterly basis. This is an important opportunity to share learning and

developments and to promote a standardised approach across Northern

Ireland.

The RASO meets with Trust Adult Safeguarding Specialists on a

monthly basis. In addition to sharing learning and ensuring

standardisation of approaches, these meetings allow the RASO to

monitor progress in relation to the NIASP annual objectives and to

identify emerging trends and issues.

The LASPs, through the Health and Social Care Trusts, provide monthly

returns on adult safeguarding activity to the HSCB and thence to the

DHSSPS, as well as annual reports through the Delegated Statutory

Functions processes.

In 2012 – 13, the RQIA conducted a “Review of Safeguarding of

Children and Vulnerable Adults in Mental Health and Learning Disability

Hospitals in Northern Ireland”. NIASP will work with colleagues in

Children’s Services and the Health and Social Care Trusts to implement

the recommendations contained within the overview report, and will

establish a mechanism to ensure regular reports on progress are

provided to the DHSSPS.



8. Activity Analysis:

This section of the NIASP Annual Report provides the key findings from

the Safeguarding Vulnerable Adults (SVA) data collection for the period

1 April 2012 to 31 March 2013. This records safeguarding activity

relating to adults at risk of harm or in need of protection aged 18 years

or over.

For the purposes of this return, an adult at risk or in need of protection is

defined as

“a person aged 18 years or over who is, or may be, in need of

community care services or is resident in a continuing care facility by

reason of mental or other disability, age or illness, or who is or may be,

unable to take care of him or herself or unable to protect him or herself

against significant harm or exploitation”.

Data for the SVA return is recorded by adult safeguarding teams within

Health and Social Care Trusts. Data is returned to the HSCB on a

monthly basis.

Between 1 April 2012 and 31 March 2013 adult safeguarding services

received a total of 5724 referrals. This is an increase of 2120 or 59% on

referrals for the same period in 2011 – 12.



Adult Safeguarding Referrals 2012 – 13

By Trust and by Programme of Care

(Total = 5724)

All Trusts reported significant increases in referral rates compared to

2011 – 12.

The majority of referrals (2054 or 36%) continue to be made to the

Belfast Trust, with the Southern Trust receiving 1476 or 26% of the total

referrals. While the Western Trust has the lowest number of referrals at

506 or 9% of the total, this still reflects an increase of 265 or 109% on

the previous year.




By Programme of Care

A total of 2064 or 36% of referrals were made on behalf of older people.

Given the size of the population of people over the age of 65 years, this

is to be expected. However, prevalence research on the levels of abuse

of older people suggests that the actual level of abuse is approximately

2% of the population or 5274 individuals. NIASP would, therefore expect

to see further increases in the referral rate for older people.

1994 or 35% referrals originated in the Learning Disability Programme of

Care. This represents approximately 23% of the population of adults with

a learning disability, which is consistent with prevalence research in

relation to the frequency with which adults with a learning disability are

subjected to some form of physical abuse.

A total of 1023 referrals were received from the Mental Health

Programme of Care. This equates to 18% of the total and is a significant

increase on referrals from the previous year where just 432 referrals

were made. While this increase is a positive indication of an increase in

staff and service user awareness of adult safeguarding issues, it should

be remembered that in at least one Trust, older people experiencing



some form of cognitive deterioration are included under the Mental

Health rather than the Older People’s Programme of Care. This may

have resulted in a slightly distorted picture of Programme of Care

activity, although it does not affect the overall totals.

Referrals from the Physical Disability and Sensory Impairment

Programme of Care increased by 235 or 95% compared to last year

which reflects high levels of awareness raising activity by LASPs.

Referrals originating in the acute sector also rose significantly,

increasing from 81 in 2011 – 12 to 160 in 2012 – 13. While this increase

is to be welcomed, there remains a considerable amount of work to be

dome to ensure that all patients in acute care settings have access to

safeguarding services.


By Category of Abuse and by Programme of Care



3036 or 53% of referrals concerned allegations or suspicions of physical

abuse, with 881 or 15% relating to allegations of financial abuse. A

further 790 or 14% of referrals referred to allegations of psychological or

emotional abuse.

However the nature of the alleged abuse is not spread evenly across

each Programme of Care. For example, the most common form of abuse

experienced by people with a learning disability is physical abuse (1517

referrals), and the least common form of abuse is institutional abuse (14

referrals). In contrast, for the Older People’s Programme of Care, the

most common form of alleged abuse was physical at 940 referrals,

followed by financial abuse at 498 referrals.

New Investigations involving Regulated Facilities and Services

By Programme of Care (Total = 2854)

0 200 400 600 800 1000 1200 1400

Acute

Learning Disability

Mental Health

Older People

Physical Health and Disability

Supported living Day care settings Adult hostel

A+E dept Statutory home Residential home

Nursing home Adult mental health unit Acute general hospital

Domiciliary Prison



A total of 2854 referrals were received where the allegation or suspicion

of abuse arose within a regulated facility or service. These referrals

account for 50% of the total number of referrals received by adult

safeguarding in 2012 - 13.

Of these referrals, 42 % or 1203 related to people with a learning

disability. 36% or 1042 referrals were in relation to people over 65 years

of age. 1016 or 35% of these referrals were in relation to acute mental

health units, which includes specialist learning disability in-patient

facilities. Adding together the categories of “Statutory Home”,

“Residential Home” and “Nursing Home”, it becomes clear that 1067 or

37% of all referrals in relation to regulated services or facilities arose

within institutional care settings.

Care and Protection Plans in Place on 31 March 2013

By Trust and by Programme of care

Care and Protection Plans are the steps taken by the Health and Social

Care Trusts, in partnership with service users, to protect the service user



from either further harm or the very real likelihood of harm. A Care and

Protection Plan is put in place from the very start of an adult

safeguarding investigation and is subject to regular review and

modification.

In 2012 – 13 the Trusts implemented a total of 3368 Care and Protection

Plans. It should be noted that this figure reflects the number of plans in

place on 31 March and not the total number of such plans put in place

throughout the year. Further analysis is required with the Trusts to better

understand the ratio of referrals to Care and Protection Plans regionally

and within each Trust and to understand the variances where, for

example the Southern Trust has only 492 Care and Protection Plans

(33% of the total number of referrals received by the Trust), compared to

1484 or 72% of referrals within the Belfast Trust. This ratio varies from

77% of referrals in the Northern Trust to 33% in the Southern Trust. It is

likely that this will be included on the NIASP audit programme for 2013 –

14.

Care and Protection Plans in place on 31 March 2013

By Programme of Care



Of the 3368 Care and Protection Plans in place on 31 March 2013, 1309

or 39% supported older people. This represents 63% of total referrals to

adult safeguarding services.

There were 1047 or 31% of Care and Protection Plans in place for adults

with a learning disability, representing 52% of all referrals.

Within the Mental Health Programme of Care, there were 740 or 22% of

Care and Protection Plans in place and within Physical Disability there

were 205 (6%) such Plans in place.

These ratios appear to reflect the different referral rates across the

different Programmes of Care.

Programme for Government Commitments:

Programme for Government 2011 – 15 included a key commitment

under Priority 3 to “introduce a package of measures aimed at improving

outcomes for children and vulnerable adults”. One of the associated

measures for this commitment is an increase in activity in relation to

adult safeguarding, both in total and across the different Programmes of

Care.

The data returns indicate that adult safeguarding services have

exceeded the anticipated levels of activity in relation both to referrals

and the number of Care and Protection Plans as follows:

REFERRAL ACTIVITY

Programme of Care

Anticipated Activity Level 2012 - 13

Actual Activity Level 2012 - 13

Older People 1109 2064

Mental Health 261 1023

Learning Disability 437 1994

Physical Sensory Disability

226 483

Total 2033 5564



CARE AND PROTECTION PLANS IN PLACE ON 31 MARCH 2013

Programme of Care

Anticipated Activity Level 2012 - 13

Actual Activity Level 2012 - 13

Older People 399 1309

Mental Health 320 740

Learning Disability 149 1047

Physical Sensory Disability

97 205

Total 665 3301

This is the third year running when Trusts have reported significant

increases in adult safeguarding activity. Some of this increase can

undoubtedly be attributed to an increased awareness of adult

safeguarding issues in the general public and amongst practitioners,

partly as a result of deliberate awareness raising activities such as the

conference on adult safeguarding in acute care settings. Referrals

following RQIA inspection visits have also increased.

However, a significant part of the increase in activity is directly

attributable to the highly developed skills and expertise of Trust Adult

Safeguarding Specialists, supported by knowledgeable and experienced

LASP Chairs.

While there has been a significant increase in resources to allow Trust

staff in particular to respond to a growing number of referrals, the adult

safeguarding service is under pressure to respond to all referrals in a

timely manner. This pressure is likely to increase as the number of

referrals progresses towards the rate suggested by the available

prevalence data. Responding to the increase in demand will require

NIASP and the LASPs to continually review not only the level of

investments available to adult safeguarding but also to review how those

resources are deployed and to identify any structural or organisational

changes that could free up resources to respond to referrals and

implement Care and Protection plans.



9. Challenges:

In developing an Action Plan for 2013 – 14, NIASP must address a

number of significant challenges. These include:

Absence of a Regional Policy Statement on Adult Safeguarding:

The absence of a policy context continues to pose challenges to

NIASP in the production of Operational Policy and Procedures and

in taking forward some of the developing areas of adult

safeguarding practice such as responding to Domestic and Sexual

Violence or Human Trafficking and Forced Marriage.

The DHSSPS intends to have a draft regional policy statement on

adult safeguarding ready for public consultation by December

2013. The proposed new policy will apply across a range of

government departments including the Department of Justice, and

will greatly assist the further development of safeguarding

services.

Growing understanding of adult safeguarding: Adult safeguarding

is a relatively new area of specialist practice. Understanding the

nature, extent and scope of safeguarding continues to grow,

through research and experience. This poses a number of

challenges both for practitioners and the structures and processes

put in place to respond to allegations or suspicions of abuse. It is

vital that practitioners are equipped with the most relevant and up-

to-date skills required for their role.

NIASP will continue to work through the Training Workstream to

enhance the skills and capacity of staff to respond to allegations of

abuse. This will include prevention as well as investigative and

protection activities.

Serious Case Reviews: As an increasing number of adult

safeguarding investigations meet the regional criteria for Serious

Adverse Incidents, NIASP will seek to ensure that all relevant

learning is identified and shared across all partner organisations.

In England and Wales a system of conducting Serious Case

Reviews (SCRs) has been set up to facilitate the identification of



all relevant learning and to disseminate that learning as effectively

as possible.

In 2013 – 14 NIASP will test the usefulness of conducting SCRs in

adult safeguarding in Northern Ireland. A pilot scheme will be set

up at the conclusion of which an evaluation report will be submitted

to NIASP and the DHSSPS which will make recommendations for

future action.

Increase in Referrals: Section 8 of this report outlined the activity

levels within adult safeguarding and highlighted an overall increase

of 59% in referrals on the previous year. This, coupled with a more

sophisticated understanding of the nature and scope of the abuse

of adults, continues to place significant additional demands on

both specialist practitioners and core services.

Significant additional investment in 2013 – 14 will assist the HSC

Trusts to respond appropriately to individual referrals. Each HSC

Trust is also engaged in streamlining and simplifying their adult

safeguarding arrangements. NIASP has a significant role in

ensuring that these developments are implemented smoothly

across the region and that there is a standardised response to all

referrals or requests for assistance.

Financial Abuse: In 2012 – 13 there was a significant increase in

the number of referrals in relation to financial abuse. This varies

from petty theft to misuse of significant levels of financial and other

assets. Following the workshop on financial abuse, NIASP will take

forward the initial actions arising from this event and other related

initiatives on this topic from the DHSSP throughout 2013 – 14.



11. NIASP WORKPLAN 2013 – 14

The NIASP workplan for 2013 – 14 is organised around 7 core themes of:

Leadership and Partnership Working;

Public Awareness and Prevention;

Access to Adult Safeguarding Services;

Effective Interventions;

The User Experience;

Training and Practice Development and

Governance and Quality Assurance.

It includes actions outstanding from the 2012 – 13 workplan and emerging issues which will require consideration

in 2013 – 14.

The Workplan sets out the objectives NIASP wishes to achieve in the coming year, presents a rationale for each of

those objectives, indicates who is responsible for leading the work and sets out the expected timescale for

completion.

The Workplan will be a core component of every NIASP meeting, with each Workstream Lead and the Regional

Adult Safeguarding Officer providing regular up-dates and reports on progress.



Theme 1: Leadership and Partnership Working:

Objective: Rationale: Lead Responsibility:

Timescale for Completion:

Finalise and begin implementation of Regional Adult Safeguarding Strategic Plan

The consultation period for the Strategic Plan is due to finish at the end of June 2013. The final version of the Strategic Plan is due by September 2013, and implementation should begin immediately thereafter.

Regional Adult Safeguarding Officer

March 2014

Meet the commitments in relation to adult safeguarding for 2013 – 14 as set out in Programme for Government 2011 – 15.

PfG contains a number of commitments aimed at “improving safeguarding outcomes for children and vulnerable adults”. These include the development of a Strategic Plan and increased activity in relation to adult safeguarding.


March 2014

Work with local Police and Community Safety Partnerships (PCSPs) to ensure that adult safeguarding issues are given appropriate consideration at a local level.

LASP Chairs will work with local PCSPs to ensure that adult safeguarding issues are prioritised within local community safety strategies and plans.

LASP Chairs March 2014



Improvement of liaison arrangements between RQIA and NIASP

NIASP will work with RQIA to ensure that lines of communication between NIASP and RQIA are effective and that adult safeguarding activities are taken forward in a collaborative, effective way.


March 2014

Finalise and complete public consultation on Operational Policies and Procedures

NIASP will produce operational guidance for practitioners that fully reflects the depth and scope of adult safeguarding activity.

NIASP Operational Policies and Procedures Workstream

March 2014

Theme 2: Public Awareness and Prevention

Introduction of Safeguarding Impact Assessment Tool

The Screening Tool developed to assist organisations assess the impact of new policies or procedures on adult safeguarding, will be rolled out to all NIASP partner organisations.


March 2014

Consider and cost the use of social media such as Facebook and Twitter to communicate key messages in relation to keeping safe

NIASP will seek to find new and effective ways to communicate with actual and potential service users to ensure that their views opinions and suggestions are used to inform future developments.

NIASP Communications Workstream

March 2014



Theme 3: Access to Adult Safeguarding Services:

Introduction of role of Safeguarding Adults Manager (SAM)

NIASP will work with all partner organisations to ensure that each organisation has an identified Senior Manager designated as the organisation’s Safeguarding Adults Manager (SAM)


March 2014

Ensure the Electronic Care Record (ECR) includes alerts in relation to adult safeguarding.

NIASP will ensure that the ECR incorporates information from SOSCARE and PARIS and is able to identify adults at risk who have an emerging pattern of attendance at Emergency Departments

NIASP Information Management Workstream

March 2014

Develop an electronic referral form to adult safeguarding

NIASP will establish an easy-to-use, standardised electronic referral form for use by all partner organisations

NIASP Information Management Workstream

March 2014

Theme 4 Effective Interventions:

Develop and begin implementation of an action plan to address financial abuse

Referrals to adult safeguarding where there is an allegation or suspicion of financial abuse continue to increase. NIASP will find ways to work effectively


March 2014



with other key stakeholders in this area such as the Office of Care and Protection and Banks, to develop an appropriate and effective response to financial abuse.

Review of the Protocol for the Joint Investigation of Cases of Alleged and Suspected Cases of Abuse of Adults.

NIASP, in partnership with the PSNI and RQIA, will revise the “Protocol for Joint Investigation of Cases of Alleged and Suspected Cases of Abuse of Vulnerable Adults” to ensure that it is relevant, up-to-date and fit for purpose.


March 2014

Work with groups of service users to evaluate at least one new or developing intervention eg the use of Non-molestation Orders in adult safeguarding cases.

NIASP will work with service users to assess the usefulness of Non-molestation Orders in adult safeguarding cases.

NIASP User Engagement Workstream

March 2014

Theme 5: The User Experience:

Pilot and evaluate a project to introduce Serious Case Reviews (SCRs) into adult safeguarding.

NIASP will work with the DHSSPS to assess the usefulness of SCRs in adult safeguarding in Northern Ireland.


March 2014



Develop and implement an audit programme that includes qualitative measures of users experience of adult safeguarding

NAISP will identify a range of audit topics each of which will include service user feedback.

NIASP User Engagement Workstream

March 2014

Theme 6: Training and Practice Development:

Review specialist training provision.

NIASP will conduct a review of the specialist training provided to support the “Protocol for Joint Investigation of Cases of Alleged and Suspected Cases of Abuse of Vulnerable Adults” to ensure that it is relevant, up-to-date and fit for purpose.

NIASP Training Workstream

March 2014

Theme 7: Governance and Quality Assurance:

Clarify and strengthen NIASP governance arrangements.

Develop and publish a governance scheme which will set out core responsibilities and accountability arrangements in relation to adult safeguarding for NIASP, LASPs and all partner organisations.


March 2014



Appendix:

NIASP membership

NAME

ORGANISATION

Aidan Gordon Social Work Western HSC Trust

Alison Conroy Criminal Justice Department PSNI

Anne McAllister Professional Officer NIASW

Anne Donaghy Chief Executive Ballymena Borough Council

Audrey Allen Area Manager AMH New Horizons

Brendan Forde AHP Consultant PHA

Christine Best Chief Executive Crossroads

Colum McQuillan Assistant Director NIHE

Desmond Lowry RCN Officer RCN

Eleanor Ross Nurse Consultant PHA

Helen Ferguson Director Carers NI

Hugh Hamill Assistant Director PBNI

Irene Sloan Director of Care Praxis Care

Janet Montgomery

Director IHCP

Jennifer Irwin Human Resources Manager Crossroads

Judith Jamison Director of People and Quality Extra Care

Kevin Keenan Assistant Director Social Care & Children's Directorate

Linda Robinson Director of Care Services Age NI

Lindsay Conway Director of Social Services Presbyterian Church in Ireland

Maire Grattan Acting Chief Executive Cause

Maria Dowds Medical Adviser Southern Health & Social Care

Marie Heaney Co-Director of Older People & Physical Disability Services

Belfast Health Trust

Miceal Crilly Assistant Director Physical and Sensory Disability

SHSCT



NAME

ORGANISATION

Michael Kelly Assistant Director SSA

Noelle Barton Assistant Director, MHOPS NHSCT

Paul Darragh Consultant in Public Health Agency HSCB

Pauline Brown Senior Services Manager Red Cross

Rosemary Magill Area Manager Women's Aid

Roslyn Dougherty

Assistant Director South Eastern Health & Social Care Board

Sarah Browne Assistant Director of Older People Services

SEHSCT

Steve Compton Chairman Action on Elder Abuse

Susan Reid CEO Victim Support Northern Ireland

Veronica Gray Safeguarding Manager Volunteer Now

NORTHERN IRELAND ADULT SAFEGUARDING PARTNERSHIP · Northern Ireland Adult Safeguarding Partnership...

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